Individual
PETER R FENWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
75 PRINGLE WAY, SUITE 505, RENO, NV 89502
(775) 786-7216
(775) 786-9365
Mailing address
780 KUENZLI ST, STE 202, RENO, NV 89502-0845
(775) 982-4590
(775) 982-5496
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4024
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11040282
CAQH
—
05
—
2016880
—
NV
05
—
2416880
—
NV
Enumeration date
06/26/2006
Last updated
02/27/2013
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